Abstract
Purpose :
To evaluate the effect of hyperopia and near visual functions on educational tests of early literacy, visual-motor integration, visual perception and attention in children.
Methods :
Children aged 4 or 5, attending preschool, and without prior glasses wear were enrolled. Cycloplegic refraction confirmed either hyperopia (≥3D to ≤6D in the most hyperopic meridian, astigmatism ≤1.5D, anisometropia ≤1D) or emmetropia (hyperopia ≤1D, astigmatism, anisometropia, and myopia <1D). Near visual functions measured were: binocular visual acuity (VA, crowded HOTV), stereoacuity (PASS), and accommodative response (Grand Seiko refractometer). Educational tests performed were: Test of Preschool Early Literacy (TOPEL), Beery-Buktenica Test of Visual-Motor Integration (VMI), Beery Visual Perception Test (VP), Leiter R Test of Attention, Cognitive Assessment System (CAS) Expressive and Receptive Attention. For each test, multiple linear regression models were built with hyperopia (yes/no), sphere, VA, accommodative lag, stereoacuity, interaction terms for hyperopia and visual functions, age, race, sex and education level of primary caregiver. Visual functions were modeled as continuous, and stepwise backward elimination was used to drop non-significant (p>0.05) vision variables; demographic features were retained in all models.
Results :
243 hyperopic (+3.8 ±0.8D) and 248 emmetropic (+0.5 ±0.5D) children completed all testing (Table 1). Individually, hyperopia and worse near visual functions were generally associated with worse scores on all educational tests. In final linear regression models, there was no significant effect of presence or degree of hyperopia or accommodative lag on any educational tests. Worse near VA was significantly associated with worse scores for each educational test and worse stereoacuity was significantly associated with worse VMI, VP, and Leiter scores.
Conclusions :
Within multivariate models, worse near VA was associated with worse scores in each educational test, and worse stereoacuity was associated with worse VMI, VP and Leiter scores. Hyperopic children have worse educational test scores and are more likely to have decreased visual functions, but hyperopia alone did not affect test scores.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.